Im often asked what’s the difference between an osteopath, chiropractor and physiotherapist? The short answer is that it depends on the practitioner and because of evidence based medicine and the fact that we all tend to read the same research literature and learn from each other we are tending to become more alike in how we practice. However there definitely are differences. Some of these are historical and philosophical and some are practical.

I think most people are probably most interested in the practical differences. Here are some of the main ones:-

What happens in a treatment—The bulk of most osteopathic hands-on sessions include massage and various types of tissue and joint manipulation. When compared to chiropractors, osteopaths do a lot more massage and less of the high velocity (joint cracking) manipulation. They also use a lot more gentle manipulation, specific positioning techniques, active resistance, and slow release of ligaments and fascia. Osteopaths traditionally have not prescribed as much exercise rehabilitation as physios but this is changing rapidly and most osteopaths like their patients to do exercise to assist in the management of chronic and recurring problems.

Length of treatment sessions- most osteopaths do 30-60 minutes treatment sessions. This tends to be longer than most chiropractors, (who may do 5-15 minute session) and similar (although probably slightly longer) to muscular-skeletal physiotherapists.

Whole body focus- Osteopaths tend to treat more than one part of the body because they are trained to always consider the ways that all parts of the body are connected. For example, a person with a shoulder problem may also have restrictions and imbalances in the ribcage and pelvis that contribute to abnormal function of their shoulder.

Healing the whole person- Historically osteopathy was concerned with healing a range of ailments, not just muscular-skeletal pain and injury. Today we can still say that the body’s self-regulating (or homeostatic) ability is enhanced when structure and physiology are balanced and efficient. Relaxation of the body and the nervous system is an important aim of osteopathic treatment because of the way this supports the healing response.

Frequency of treatments- Osteopaths tend to treat less often than chiros and physios. I believe that the combination of long treatment times, whole body focus, and variety of treatment techniques that focus on the whole body and work on different types of tissue mean that people tend to get better with less number of treatments.

Skill and Training

Osteopaths, chiropractors and physiotherapists all undertake 4- 5 years of university education (usually to the level of master’s degree). I would argue (and some might disagree) that osteopaths probably get the best training in massage and soft tissue skills. They are extensively trained in specific osteopathic techniques that require high levels of sensitivity, focus and interpretative touch.

Many people say they love the feeling of wellbeing and relaxation they experience with osteopathic treatment. Perhaps it’s because they can feel that the osteopath is thinking with their hands, interpreting and responding to what’s under their hands; adjusting technique, pressure and position as the tissues change during the treatment.

Results- Treatment results depend on the skill of the practitioner, whether osteo, chiro or physio and the fit they and the techniques they use have with the patient and/or their condition.

If you want to read a bit more about the philosophy of osteopathy. Here is are a couple of links.